This is a post I’ve been meaning to do for a while. When I first became interested in health tech, the great Uli Chettipally suggested making small angel investments as a way to gain experience, make connections, and create advisory opportunities. At the time, I knew absolutely nothing about entrepreneurship, investing, startups, funding rounds, venture capital, etc. Series A, B, and C were labels for luxury car models as far as I was concerned. A few years and several investments later, I now know slightly more than nothing and a little less than something about angel investing. In this post, I’ll share my approach to investing including my philosophy and thesis (so much as they exist) and detail my current portfolio. I’m trying to have fun with it — hence the “re-brand” from the Schwartz Fund to Dem Bones Ventures (complete with logo courtesy of Dall-E!).
First, Disclaimers and Disclosures
Before I dig in, let’s talk disclaimers and disclosures:
Disclaimer #1 - What follows is not investment advice. Angel investing is risky, most startup companies fail, and average return (IRR) is typically around 20-25%. You can and will lose money (maybe all of it), and there are far safer and more predictable ways to invest. The web is replete with resources about angel investing, and there are any number of groups to join, people to follow, and courses to take that are beyond the scope of this post. Investopedia does a nice breakdown here, and this Forbes article provides some insight from experienced angel investors. Personally, I started making small investments to get involved in the health tech ecosystem, scratch an entrepreneurial itch, and satisfy my desire to always be learning and growing. I don’t expect to get rich from my portfolio and won’t be quitting my day job any time soon. But so far, my goals have largely been achieved.
Disclaimer #2 - This is not a solicitation for investment opportunities. While I appreciate that the current fundraising environment is very challenging, I am not actively looking to invest. I appreciate the passion that all founders have for their companies and dedication to the mission and vision. Again, I am not looking to invest. Thank you in advance for respecting my inbox. That said, I am open to advisory roles and compensated consulting arrangements. When people reach out to me in earnest, I try my best to offer feedback when I feel I have something useful to contribute (tokens of appreciation are always…uh, appreciated). Keep in mind, I still operate/see patients 5 days a week, and my wife and kids still seem to like it when I’m around and available (the dog, I’m not so sure). In conclusion, no investment solicitations please!
Disclosure - I am biased. The following article is biased. While I believe in all my “portfolio” companies and have gotten to know many of the founders and team members on a personal level, I have a clear financial interest in the success of all the startups mentioned here. What follows should be viewed through that lens. If I have a brand or ethos, I hope it’s one of earnestness and transparency. I’m writing this largely to share my experience, to serve as an official record I can reference in the future, and because I enjoy it. There is unquestionably a self-serving, shameless promotion angle to this post. I do not speak for these companies or their founders, but I’m almost certain they are all open to funding and partnership opportunities. I can and will personally vouch for the founders represented here — they’re great people, and I’m honored to play a small part in their journeys.
Thesis, Philosophy, Approach
If I claimed to have a clear thesis, defined philosophy, and well thought out approach when I started, I’d be lying. My general interests are the marriage of healthcare technology and innovative care models with a focus on MSK. In general, I invest mostly based on believing in the company/founder, feeling I have something to contribute (formally or informally), and wanting to have some skin in the game. My goal is to leverage my experience on the frontlines to invest in products and services that address an actual problem in a sustainable way. Nothing particularly earth shattering there, and we all know healthcare is complex and hard to predict. The unfortunate thing is that there are some really great ideas that simply don’t have a path to profitability, sustainability, or widespread adoption. Such is the nature of American medicine.
I write small (low 5-figure checks), and my grand hack is that I largely fund investments using money I make from side gigs. I do my own due diligence which typically involves a conversation with the founder, looking over the slide deck, going to the company website, and doing some high-level market analysis. Intuition plays a role too, and I often mull over an investment for months before pulling the trigger (it’s too early to tell if my intuition is solid or suspect). Most of my deals are sourced through social media connections and health tech communities although some relationships go as far back as the halcyon days of Clubhouse. In essence, I serve as my own GP, LP, and venture scout. So, I have no one to blame or exalt but myself. (As of this writing, I do not own any Allbirds or Patagonia vests, am not a huge Kombucha fan, and don’t wear a backpack. I have, however, read “Zero to One.”)
Most of my investments are managed through Carta. It’s a simple and straightforward platform that makes it easy to track and execute SAFEs, exercise options, and aggregate investments. Carta also has some nice angel investment learning resources. A couple of my investments are through AngelList special purpose vehicles (SPV). It’s a similar platform with the advantage that AngelList lets you manually add and track the progress of investments (including multiples and IRR) based on additional funding rounds. In that sense, AngelList is a bit more robust and provides a good snapshot of my entire portfolio.
The Portfolio
The following is a list of my angel investments in chronological order including date of investment, company categories, and founder(s). There’ll be a brief synopsis of the product/service followed by my thoughts on the company and its offerings. While I have a financial interest in all these companies, they do not compensate me for promotion, and this post was my own idea. Out of respect for the founders, I sent them a preview version of this article and allowed them to provide feedback. Finally, you’ll find that my portcos feature physician, female, and minority founders. I’d love to tell you this was intentional and part of some larger investment thesis. It wasn’t — it just kinda happened that way.
Healent Health (www.healent.com)
Date of Investment: February 2020
Founder: Anoop Adya
Categories: Care Management, RPM/RTM
Healent helps physicians optimize their practices, innovate, and collaborate with patients to improve treatment pathways through data insights. The company calls it “Medicine 3.0.” Healent’s solution is 100% SaaS-based and was incorporating AI-powered tools long before everyone else started doing it. The company has experienced tremendous organic growth in MSK and Chronic Pain and now boasts two of the biggest Pain Management practices among its customers. The company has been funded solely by angel investments and has bootstrapped itself to over 1 million contracted patients with partner practices that span the entire country.
Healent will always hold a special place for me as my first angel investment. When I invested, the company was called Kitchry and was in the process of pivoting from a nutrition solution that connected patients to dieticians to a platform for MSK patient optimization. Shortly after the money was transferred, the pandemic hit, and I suddenly had a lot of time on my hands. In the early days, I spent many hours brainstorming with Anoop on PMF, pitches, slide decks, building the platform, and the like. I presented the company during virtual health tech events and pitch competitions and got some experience in product development. I didn’t realize it at the time, but it was the perfect crash course on startups — real world, on the job training. As the pandemic faded and my day job resumed, my role with Healent shifted to more of an ad hoc advisor. Anoop has assembled a tremendous team including an All-Star CEO, Mike Palackdharry (himself an exited founder).
Quadrant Eye (www.quadranteye.com)
Date of Investment: July 2020
Founder: Quinn Wang, MD
Categories: Virtual Care, Telehealth, Telemedicine
Quadrant Eye (QE) started with a simple mission, bringing high-quality eyecare to all. Like many aspects of our healthcare system, access to Ophthalmologic care and eye health services is limited for far too many patients. QE aims to make at-home eyecare the norm by creating scalable technology that utilizes everyday devices like cellphones, tablets, and desktop computers. The company was part of Y Combinator’s W21 batch and counts Khosla Ventures and the creator of Google Image Search as backers. What QE is trying to achieve is complex but critically important in helping prevent blindness and improving access to eyecare.
Why does an Orthopedic Surgeon invest in an Ophthalmology company? Quinn was one of the first physician-founders to reach out to me, mostly to compare notes on our lives as surgeons and health tech entrepreneurs. (I think she secretly wanted to figure out if I was for real). I was struck by Quinn’s intensity and drive and felt. The concept and vision (no pun intended) of accessible, tech-enabled eyecare made a lot of sense. QE addresses a huge need and, though I don’t know too much about eyes, I do know how frustrating it can be to navigate specialty services.
PatchRx (www.patchrx.io)
Date of Investment: May 2021
Founders: Gavin Buchannan, Andrew Aertker
Categories: Remote Monitoring, Care Management
PatchRx uses smart technology and personal care staff to support adherence and help patients manage their medications. Using a smart pill bottle cap, the platform collects information and provides insights to healthcare providers allowing them to develop more personalized treatment plans. Virtual and onsite nursing support ensures that patients receive the care they need both at home and in the clinic setting. PatchRx became the first vendor to offer an RTM-supported medication adherence platform under new Medicare rules supporting remote monitoring. The company has raised $15 million to date including an $8 million Series A round in August of this year led by Atento Capital (with participation from Vast Ventures, Cortado Ventures, Forum Ventures, and Plains VC).
Gavin Buchanan reached out to me in December 2020 looking for feedback on his company and its mission to make managing medications easier. We don’t do a lot of long-term medication management in Orthopedics, but we are one of the largest prescribers of opioid pain medications. At the time Gavin contacted me, the movement to reduce postop narcotic medication usage following joint replacement surgery was gaining a lot of momentum. (I’m happy to say we’ve made a lot of progress there over the past 3 years). Having a platform that could track how patients took medications after surgery piqued my interest and represented another area of need. I thoroughly enjoyed my conversation with Gavin (who has a great founder story) and invested a few months later.
PrecisionOS Technology (www.precisionostech.com)
Date of Investment: July 2021
Founder: Danny Goel, MD
Categories: Medical Education, Virtual Reality
PrecisionOS is a virtual reality-based solution for medical education that provides an immersive learning environment. Put simply, the company is creating the future of surgical training through an unprecedented level of realism and skill acquisition. While use cases are many, the current focus is on Residency Programs and Medical Device companies. PrecisionOS allows residents to build practical skills by performing procedures in a virtual environment. The platform offers real time feedback to allow learners to hone their skills. For trainees and their programs, the PrecisionOS represents an accessible and cost-effective way to reach competency thresholds and achieve surgical mastery. PrecisionOS has formed numerous global partnerships with leading institutions and top medical device companies. In March 2023, PrecisionOS received a prestigious $1.5 million grant from the Government of Canada’s Business Scale-Up and Productivity Program.
I was a virtual reality skeptic. Although I love technology and gadgets, VR seemed gimmicky, and I didn’t pay it much attention. Danny, an Orthopedic Surgeon, convinced me to buy an Oculus Quest 2 headset and try the PrecisionOS platform. From the tutorial, I was hooked. Surgical training hasn’t changed much in years — it’s done in cadaver labs and the OR with limited ability to repeat or practice procedures. The process is expensive, inefficient, and antiquated. PrecisionOS intends to spur medical education and surgical training into the 21st century. I’m especially impressed by Danny and his team’s commitment to the scientific method and an evidence-based approach. The company has the most evidence behind its educational approach as found in well-respected journals. Many residency programs are already working with them to integrate the solution and have also published several papers on the effectiveness of their software. PrecisionOS’ VR-based training is unique in many ways as they continue to pursue substance over hype. It explains why they’ve become the trusted partner for not only residency programs, but orthopedic societies as well.
MDisrupt (www.mdisrupt.com)
Date of Investment: October 2021
Founder: Rudy Gadelrab
Categories: Fractional Executives, Advisory/Consulting Services, Product Evaluation
MDisrupt’s mission is to help digital health companies bring their products and services to market in a responsible, data-driven, and evidence-based way. The company is solving the problem of how to separate hype from reality in health tech to ensure that products lead to improved health outcomes. Digital health has entered a new phase where investors, payors, employers and others are looking for proof of impact. MDisrupt realized long before the current headwinds that the future of health tech depends on data generation, outcomes measurement, and close collaboration with experienced healthcare leaders. The company offers a robust suite of solutions including clinicians and operators on-demand, medical advisory boards, focus groups, product feedback, and custom solutions. MDisrupt raised a $6 million Seed Round in March 2022 followed by an additional $3 million in October 2023.
Ruby is one of the founders I first got to know back in the Clubhouse days of the pandemic. Her levelheaded approach and voice of reason stood out in an environment that at times felt mildly hostile toward traditional healthcare and seemed more focused on style over substance. MDisrupt answers the question of who watches the watchers. Ruby and I are sympatico on the idea that the sustainability and viability of digital health hinges on evolving the ecosystem. I’ve had the pleasure of meeting Ruby in person — she’s a force and has been a great supporter of my own health tech journey.
Commons Clinic (www.commonsclinic.com)
Date of Investment: October 2022
Founder: Nick Aubin
Categories: Care Delivery, MSK, Value-based care
Commons Clinic provides bundled care for Orthopedic conditions with transparent pricing and a focus on patient experience. Currently operating in the LA market, Commons Clinic offers hybrid MSK care with access to heavily vetted expert physicians, state of the art surgery centers, unlimited digital support, and all-inclusive surgical programs. The company aims to evolve the Orthopedic care experience by providing a tightly integrated, comprehensive care journey. Commons Clinic is pushing value based MSK care forward by offering guaranteed pricing and direct care. The company is working with payors to design sensible VBC programs (something that’s sorely lacking). The company announced a $19.5 million Series A round in October 2023 led by RA Capital Management with participation from Floating Point and Courtside Ventures among others.
Innovative, value-focused, tech-enabled MSK care is my passion. I write about it often and have my own vision of what MSK 2.0 looks like. Nick Aubin and Commons Clinic get it. I’m a big fan of what Nick is building, and investing in Commons Clinic was a no-brainer for me. The handful of conversations I’ve had with Nick always leaves me energized about what’s possible in building the next generation of MSK care. I’m also a believer that building the future of MSK care requires the marriage of virtual and brick-and-mortar care with sensibly implemented technology. Too often the two are at loggerheads with the belief that value can only be attained by keeping patients away from Orthopedic Surgeons. The potential here is enormous, and I’m honored to play a small part.
Ease (www.easepractice.com)
Date of Investment: July 2023
Founder: Mario Amaro, MD
Category: Practice Management
Ease is building an AI-powered assistant to help doctors start, grow, and manage their practices with AI. The Ease Assistant allows doctors to build tech-enabled practice models in minutes, increasing efficiency with front- and back-office operations, while integrating the latest tech products directly into their clinical workflows with no development assistance. Once the practice is launched, Ease will assist with tasks such as managing scheduling, note-taking, bookkeeping, processing payments, claims, payroll, and more. We’re in an era where more physicians are employed than at any other time in history. Burnout is rampant among all clinicians, and too many are leaving the frontlines of healthcare — in large part because of lack of autonomy and frustration with the system. Ease aims to reverse that trend and make it easier for clinicians to maintain their independence and re-discover their joy for medicine. Ease (then called DocSpace) secured a $1.2 million seed investment from Precursor Ventures in August 2021 along with funding from the Google for Startups Latino Founders Fund.
Mario Amaro, MD is as passionate an individual as you’ll find. He’s well worth a follow on Twitter/X for his takes on physician independence and the future of medical practice. Ease was a company that stayed on my radar screen for a long time before I decided to make an investment. Healthcare is at a crossroads and all things are cyclical. I suspect we're on the verge of a shift away from employed positions to small, independent practices that put the focus back on the doctor-patient relationship. Clinicians will be putting out a shingle (just like the old days), and Ease will be there to support that transition.
Mishe (www.mishe.co)
Date of Investment: November 2023
Founders: Sidney Haitoff and Sandeep Palakodeti, MD, MPH
Categories: Direct Care, VBC, Care navigation
Mishe (pronounced “Mish-e”) aims to simply healthcare by cutting out the middlemen. The platform provides access to high quality care with transparent, pre-negotiated pricing. Company ethos is a world where all patients have access to affordable, high value care without fearing unknown costs. The process is simple: Mishe helps patients find care, book care, and get care. Prices are clearly listed and negotiated ahead of time, care is pre-paid, and an appointment is scheduled. As we push towards a healthcare future of consumer choice and direct care, Mishe lets patients shop confidently online for care, easily schedule visits, and coordinate the care process. For clinicians, participating with Mishe simplifies care delivery and eliminates the complexities and frustrations associated with commercial and governmental insurance. It’s a win-win for patients and clinicians. Mishe’s initial focus has been on the New York market, and the platform is trusted by NYC area facilities like NY-Presbyterian, Northwell Health, NYU Langone, and Mt. Sinai. The company is growing quickly and looks to expand beyond New York in the near future. Mishe was part of Techstars’ NYC Spring 2023 class.
The direct care movement is gaining momentum. It’s tempting to envision a future where patients find high value care through a vetted marketplace with transparent pricing and a concierge-like experience. I always enjoy my conversations with Sid and Sandeep where we inevitably end up down any number of rabbit holes. Mishe’s current vision is bold — their long-term vision is even bolder. If the only way to win the game is not to play it, Mishe aims to reinvent the game. I’m honored not only to be an investor but to also join the Medical Advisory Board.
Bonus: “Alternative” Investments
The above angel investments were made the traditional way via SAFE or SPV. But my portfolio also includes some “alternative” investments that are the result of compensation for rendered services. Accepting stock or stock options as remuneration is considered high-risk, high reward — especially in today’s uncertain funding and exit environment. However, equity compensation is commonly used by startup companies to manage burn and conserve capital while incentivizing employees and rewarding advisors.
Doximity (www.doximity.com)
Equity compensation: Stock options
Status: Exited
I served as Doximity Op-Med Fellow from 2019-2020 which involved writing a series of articles to be published on the platform. Per the website, Op-Med “provides clinicians authors…a place to share thoughts, opinions, and knowledge with the largest medical community in the United States.” It was an enjoyable experience that allowed me to hone my writing skills and reach an audience of my peers. The requirements of the program weren’t onerous, and as compensation, Doximity offered stock options that could be exercised at a reasonable strike price. Shortly after my shares were issued, Doximity went public through an IPO — just like I planned it! It stands as my first, and as yet, only exit. Since IPO’ing, Doximity’s stock has been up and down and is significantly off its all-time high as of this writing. Still, the Op-Med experience was well worth it, and the stock options and subsequent exit were icing on the cake.
Sword Health (www.swordhealth.com)
Equity Compensation: Stock options
Status: Vesting
There are a lot of virtual MSK companies, and I’ve had some form of contact or conversation with just about all of them. While I still believe the future of MSK care involves a hybrid approach, I’ve been closely following Virgilio “V” Bento and his team at Sword Health. “V” was gracious enough to connect with me and compare notes on the evolution of his company and his vision for musculoskeletal care. I came away impressed by his earnestness. I’ve sometimes been critical of the whole virtual MSK ethos of “avoiding unnecessary procedures” and the friction between digital health companies and Orthopedic Surgeons. Not only did “V” acknowledge my critiques, but he also opened the door for me to collaborate with Sword on a side project. For the past several months, I’ve been doing some consulting with Sword on a new platform offering and have enjoyed getting to know Luis Ungaro, Catarina Sousa, and company co-founder Fernando Correia, MD, PhD. As compensation, the company has offered stock options with a one-year vesting period. “V” is on record that Sword is hoping to achieve profitability before pursuing an IPO in 2024. Stay tuned.
Wrapping Up
So that’s Dem Bones Ventures. It’s been a fun journey that’s just getting started. Not only have I achieved my goal of learning more about angel investing and entrepreneurship, but I’ve also made some great connections. I’m reinvigorated about the future of healthcare. Looking back, some common threads have emerged, perhaps by accident but more likely shaped by my own interests and thoughts on where healthcare is headed. I’m appreciative that these companies and their founders have allowed me to play a small part in their journey and welcomed me to their cap tables. It’s tough out there, but 2024 may offer a light at the end of the tunnel.